Monthly Archives

November 2018

Medicare Releases Mandated Report on Medicare Telehealth Utilization, Barriers & Opportunities

By | National Telehealth Policy Resource Center Blog

In response to a requirement in the 21st Century Cures Act to issue a report on telehealth use, barriers and opportunities in Medicare, CMS released an informational report on November 15th addressing the four required elements, including the following:

  1. Identification of Medicare beneficiaries whose care may be improved most by telehealth services;
  2. Activities by the Center for Medicare and Medicaid Innovation that examines the use of telehealth;
  3. The types of high-volume services that might be suitable to be furnished using telehealth; and
  4. The barriers that are preventing telehealth’s expansion.

The document employs data from Medicare Fee for Service (FFS) between 2014 and 2016, reporting that although overall use of telehealth has increased, the rate of adoption is still limited.  For example, in 2016, approximately 90,000 Medicare beneficiaries utilized 275,199 telehealth services which constitutes just one-quarter of a percent of the 35 million FFS Medicare beneficiaries.  Mental health and therapy sessions were the most common service types, with beneficiaries with a mental health diagnosis among the highest utilizers of telehealth delivered services.  Services targeting chronic diseases and behavior modification (such as smoking cessation) were also among the more popular telehealth delivered services.  One of the most illuminating findings from the report was that if only 1% of Medicare’s in-person visits occurred over telehealth, it would result in a thirteen fold increase in telehealth delivery.  The analysis determined that there are 19 additional high volume services for outpatient and inpatient visits and therapy that are either similar to those that are already on Medicare’s list or that are typically provided in settings that do not meet Medicare’s originating site requirements that would be suitable for telehealth delivery.

The report also recognizes the role telehealth could play in fighting substance use disorder, citing studies that indicate improved results for telehealth SUD treatment programs’ completion rates compared to in-person programs.  The report states that “telehealth seems to provide the intervention most similar to office-based treatment, and research shows that telehealth patients, while not specific to Medicare, have satisfaction levels and outcomes similar to those of clients receiving in-person therapy.”

CMS concludes that restrictions on eligible telehealth originating sites is the greatest barrier preventing the expansion for telehealth within Medicare.  Specifically the requirement the beneficiary be located in a rural area and excluding the home as an originating site (with the exception of certain conditions) has resulted in the low utilization levels.  The report acknowledges telehealth’s potential not only for Medicare rural beneficiaries but also to those in non-rural areas, racial and ethnic minorities and the elderly with multiple chronic conditions many of whom are currently restricted from accessing telehealth solely by their physical location.
For more details and further statistics on telehealth in Medicare, see the full report.


By | National Telehealth Policy Resource Center Blog

CMS Proposes Changes to Medicaid Network Adequacy Standards

In a proposal released on Nov. 8, 2018, CMS proposed changes to regulations on network adequacy standards. The changes would allow states to elect alternative quantitative standards to measure network adequacy, including but not limited to, minimum provider-to-enrollee ratios; maximum travel time or distance to providers, maximum wait times for an appointment, and other quantitative standards. Currently, regulations require states to establish network adequacy standards by developing and enforcing time and distance requirements for specified specialty providers. States have commented that these measurements are sometimes inaccurate, especially in locations where telehealth services are heavily used, where a provider-to-enrollee ratio provides a more accurate representation of access.
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4th Annual Service Provider Summit – If You Missed It You Missed a Lot!

By | Southwest Telehealth Resource Center Blog

By Elizabeth A. Krupinski on Nov 07, 2018

The 4th Annual Telemedicine & Telehealth Service Provider Summit (SPS, sponsored by the Arizona Telemedicine Program (ATP) and Southwest Telehealth Resource Center (SWTRC), was held October 8-9 in Glendale, AZ, and attracted an all-time high of nearly 400 attendees! SPS continues to be unique in its intent to bring together telemedicine service providers and users in a collaborative and interactive venue that provides the opportunity to learn from each other. SPS, as in past years, was organized and hosted by Drs. Dale Alverson, Elizabeth Krupinski, and Ronald Weinstein. The ATP team contributed innumerable hours (especially Nancy Rowe and Kris Erps), support, and enthusiasm to put the meeting on and deserves many kudos and thanks (Cassandra Coray, Ellen Dudzik, Kris Erps, Mike Holcomb, Angel Holtrust, Bob Kerr, Janet Major, Chris Martin, Karen Miller, Nancy Rowe, Tracy Skinner)!

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By | National Telehealth Policy Resource Center Blog

Last week CMS released its finalized Calendar Year (CY) 2019 Physician Fee Schedule containing momentous changes for Medicare, aiming to modernize the healthcare system and help “restore the doctor-patient relationship” by reducing administrative burden. Among the changes, the proposed rule not only expands telehealth reimbursement, but communicates a new interpretation by CMS of the applicability of their statutory requirements for reimbursement of telehealth. Telehealth-delivered services under Medicare is limited in statute by 1834(m) of the Social Security Act which limits the use of telehealth to certain services, providers, technology (mainly live video) and patient locations (needing to be in certain types of healthcare facilities in rural areas). CMS, in their rule, expresses concern that these requirements may be limiting the coding for new kinds of services that utilize communication technology.

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